Revista Panamericana de Salud Públicahttps://www.scielosp.org/feed/rpsp/2016.v39n4/2018-01-01T00:02:00ZVol. 39 No. 4 - 2016WerkzeugGaps in health research in the Dominican RepublicS1020-498920160004001792018-01-01T00:02:00Z2018-01-01T00:02:00ZCanario, Julio ArturoLizardo, JefreyEspinal, RobertoColomé, Manuel
<em>Canario, Julio Arturo</em>;
<em>Lizardo, Jefrey</em>;
<em>Espinal, Roberto</em>;
<em>Colomé, Manuel</em>;
<br/><br/>
ABSTRACT Objective To provide a basic profile of health research in the Dominican Republic by identifying health problems or diseases that have been addressed by studies implemented during the period 2009–2013 and to determine how well that research correlates with the burden of disease in the Dominican population. Methods This was a descriptive study that searched for primary and secondary data sources to identify health research implemented in the Dominican Republic in the years 2009 to 2013. Data about these projects were collected from the registries of clinicaltrials.gov and the Consejo Nacional de Bioética en Salud, as well as from a questionnaire directed to researchers and managers. Disability-adjusted life years (DALYs) were derived from the Global Burden of Disease Study 2013 for males and females of all ages in the Dominican Republic and then compared with the number of research studies conducted on each specific health condition. Results This study identified 313 health research projects conducted in the Dominican Republic during the years 2009–2013. HIV/AIDS and lower respiratory infections were the two main topics researched; however, they accounted for a relatively small percentage of total DALYs in males and females of all ages in the Dominican Republic in 2013. Conclusions Limited research is directed toward addressing the health needs of Dominicans. The ongoing process of setting priorities for health research in the Dominican Republic should direct its efforts toward fixing this imbalance.Prevalence of chronic kidney disease of non-traditional causes in patients on hemodialysis in southwest GuatemalaS1020-498920160004001862018-01-01T00:02:00Z2018-01-01T00:02:00ZLaux, Timothy S.Barnoya, JoaquinCipriano, EverHerrera, ErickLopez, NoemiPolo, Vicente SanchezRothstein, Marcos
<em>Laux, Timothy S.</em>;
<em>Barnoya, Joaquin</em>;
<em>Cipriano, Ever</em>;
<em>Herrera, Erick</em>;
<em>Lopez, Noemi</em>;
<em>Polo, Vicente Sanchez</em>;
<em>Rothstein, Marcos</em>;
<br/><br/>
ABSTRACT Objective To document the prevalence of patients on hemodialysis in southwestern Guatemala who have chronic kidney disease (CKD) of non-traditional causes (CKDnt). Methods This cross-sectional descriptive study interviewed patients on hemodialysis at the Instituto Guatemalteco de Seguridad Social on their health and occupational history. Laboratory serum, urine and vital sign data at the initiation of hemodialysis were obtained from chart reviews. Patients were classified according to whether they had hypertension or obesity or neither. The proportion of patients with and without these traditional CKD risk factors was recorded and the association between demographic and occupational factors and a lack of traditional CKD risk factors analyzed using multivariate logistic regression. Results Of 242 total patients (including 171 non-diabetics) enrolled in hemodialysis in southwestern Guatemala, 45 (18.6% of total patients and 26.3% of non-diabetics) lacked traditional CKD risk factors. While agricultural work history was common, only travel time greater than 30 minutes and age less than 50 years old were significantly associated with CKD in the absence of traditional risk factors. Individuals without such risk factors lived throughout southwestern Guatemala’s five departments. Conclusions The prevalence of CKDnT appears to be much lower in this sample of patients receiving hemodialysis in Southwestern Guatemala than in hospitalized patients in El Salvador. It has yet to be determined whether the prevalence is higher in the general population and in patients on peritoneal dialysis.Prevalence of cervical cancer and associated mortality in Grenada, 2000–2010S1020-498920160004001942018-01-01T00:02:00Z2018-01-01T00:02:00ZBahadoor-Yetman, A.Riley, L.Gibbons, A.Fields, P. J.Mapp-Alexander, V.Hage, R.Baldwin, A.
<em>Bahadoor-Yetman, A.</em>;
<em>Riley, L.</em>;
<em>Gibbons, A.</em>;
<em>Fields, P. J.</em>;
<em>Mapp-Alexander, V.</em>;
<em>Hage, R.</em>;
<em>Baldwin, A.</em>;
<br/><br/>
ABSTRACT Objective To assess cervical cancer prevalence and associated mortality in Grenada, West Indies during 2000–2010. Methods Records of visits to hospital and clinical facilities were obtained from the histopathology laboratory of the Grenada General Hospital. Records were de-identified and electronically compiled. Cervical cancer prevalence was assessed via cross-sectional analysis of this secondary data. Of a total 12 012 records, 2 527 were selected for analysis using sampling without replacement. Cases were matched to corresponding patient data from death registries, where possible, and used to calculate associated mortality rates. Results The observed prevalence of cervical cancer was 52.4 per 100 000 women (ages 15 and above). The highest rates of cervical cancer occurred in the 35–44 age group, with the second highest among 45–64-year-olds. A total of 65 deaths were attributable to cervical cancer during 2000–2010, more than 50% of which were among women > 65 years old. The observed mortality rate was 16.7 per 100 000, almost twice the rate estimated by WHO for the region. Conclusions This study demonstrates the need for a comprehensive cervical cancer-screening program in Grenada. Results should contribute to informing future studies on how to appropriately generate and execute public health policy for education, screening, prevention, and control of cervical cancer in Grenada.Energy interventions that facilitate sustainable development and impact health: an overview of systematic reviewsS1020-498920160004002002018-01-01T00:02:00Z2018-01-01T00:02:00ZHaby, Michelle M.Chapman, EvelinaClark, RachelGalvão, Luiz A.C.
<em>Haby, Michelle M.</em>;
<em>Chapman, Evelina</em>;
<em>Clark, Rachel</em>;
<em>Galvão, Luiz A.c.</em>;
<br/><br/>
ABSTRACT Objective To inform policy by providing an overview of systematic reviews on interventions that facilitate sustainable energy use and have a positive impact on health. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations through a comprehensive search of 13 databases and nine websites based on a pre-defined protocol, including clear inclusion criteria. Both grey and peer-reviewed literature published in English, Spanish, and Portuguese during the 17 years from January 1997 – January 2014 was included. To classify as “sustainable,” interventions needed to aim to positively impact at least two dimensions of the integrated framework for sustainable development and include measures of health impact. Results Five systematic reviews and one economic evaluation met the inclusion criteria. The most promising interventions that impacted health were electricity for lighting and other uses (developing countries); improved stoves for cooking and health and/or cleaner fuels for cooking (developing countries); and household energy efficiency measures (developed countries). These interventions also had potential environmental and economic impacts. Their cost-effectiveness is not known, nor is their impact on health inequalities. Conclusions What is needed now is careful implementation of interventions where the impacts are likely to be positive but their implementation needs to be rigorously evaluated, including possible adverse impacts. Care needs to be taken not to exacerbate health inequalities and to consider context, human behavior and cultural factors so that the potential health benefits are realized in real-life implementation. Possible impact on health inequalities needs to be considered and measured in future primary studies and systematic reviews.Desenvolvimento de um dispositivo eletrônico para organizar medicamentos e promover a adesão medicamentosaS1020-498920160004002082018-01-01T00:02:00Z2018-01-01T00:02:00ZVieira, Liliana BatistaRamos, Celso de ÁvilaCastello, Matheus de BarrosNascimento, Lorenzo Couto do
<em>Vieira, Liliana Batista</em>;
<em>Ramos, Celso De Ávila</em>;
<em>Castello, Matheus De Barros</em>;
<em>Nascimento, Lorenzo Couto Do</em>;
<br/><br/>
RESUMO O presente artigo descreve o desenvolvimento de um protótipo eletrônico para organizar medicamentos, denominado Sistema Eletrônico de Uso Personalizado e Controlado de Medicamentos (SUPERMED). O protótipo inclui uma gaveta que contém os medicamentos a serem utilizados durante 1 mês, alarme sonoro e visual programado para disparar nos horários de administração dos medicamentos e registro dos horários em que a caixa foi aberta (horário previsto ou fora do horário previsto) gravado em cartão de memória e posteriormente transferido para leitura em computador. Para o desenvolvimento do protótipo, seguiu-se o modelo de prototipação evolucionária. O SUPERMED foi projetado sobre a plataforma Arduino e a programação foi desenvolvida em linguagem C. Para leitura do sistema de alertas e registro dos horários de abertura da caixa, desenvolveu-se um software em linguagem Java. Uma vez feita a programação dos alarmes (idealmente por um profissional da área de saúde), não há nenhum ajuste adicional a ser feito pelo paciente. As funcionalidades do protótipo foram testadas durante 31 dias pelos pesquisadores, com funcionamento bem-sucedido. O sistema parece adequado para organizar os medicamentos e facilitar a adesão medicamentosa. Novos estudos serão realizados para validar a aperfeiçoar o protótipo.